The use of allogeneic grafting has become a standard methodology to increase bone volume in deficient areas of the maxilla and mandible. The purpose of this grafting procedure is to prepare the patient for the eventual restoration of the patient's function and esthetics with dental implants.
Conventionally, this procedure involves the surgical exposure of an area of deficient bone in the jaws, removal of a section of freeze dried iliac crest from a tissue bank, contouring the section from the iliac crest to follow the anatomical curvature of the target area of the jaw in which it is to be implanted and adapting the section of iliac crest to passively rest on the jaw with maximum contact with the existing bone matter. The section of allogeneic bone is then fixated to the deficient jaw for approximately four months to allow fusion of the allogeneic bone to the jaw and eventual replacement with autologous bone.
As described, the process is routine yet difficult. The most time consuming and critical aspect of the procedure involves the adaptation of the section of iliac crest to a deficient mandible. If there is poor adaptation, insufficient area contact, and/or a lack of stability at the time of fixation between the graft and the recipient jaw, the graft will fail to fuse and the patient will not receive any benefit from the graft procedure. Conventionally, the process which is utilized in the operating room or clinic involves the use of several different carbide burs to contour the surface which interfaces with the native jaw. Thus, once the surgical exposure is completed, the surgeon visualizes the recipient's site and through memory and repetitive test insert procedures, the surgeon will endeavor to produce the negative equivalent of the recipient site jaw contour in the allogeneic section. More specifically, the section of iliac crest is stabilized by the surgeon's hand or with an instrument while a rotary instrument on a handpiece is used to remove minimal amounts of bone to follow given contours of the jaw.